Patient-delivered partner therapy in the UK: what do patients think?

Shivasankar, Sivapatham; Challenor, Rachel; Ekanayaka, R

doi:10.1258/ijsa.2008.008004

Cited by 12 publications

(9 citation statements)

References 6 publications

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“…Patient referral is the most common and preferred method of PN for curable STIs in the UK 5,6,14 but in most sexual health care settings it fails to reach half of exposed sexual partners requiring treatment. 1,3 Primary health-care providers are already undertaking elements of EPT in their current practice.…”

Section: Discussionmentioning

confidence: 99%

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Is accelerated partner therapy a feasible and acceptable strategy for rapid partner notification in the UK?: a qualitative study of genitourinary medicine clinic attenders

et al. 2009

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Partner notification (PN) in the UK is of limited effectiveness. Expedited partner therapy improves PN outcomes but does not comply with existing UK professional guidance. We developed two new strategies, known as accelerated partner therapy (APT), based on elements of PN practice for which there is evidence of efficacy, and which conform to UK prescribing guidance. We explored the acceptability and feasibility of these models qualitatively in genitourinary medicine clinic attenders. Both strategies were viewed favourably. Preference was influenced by age, relationship type, whether participants were delivering or receiving APT and whether the sex partner was aware of the participant's clinic visit. APT provides a new approach to PN, which has strong patient support and complies with existing UK regulations. The complex factors that influence patients' choice of PN method suggest that provision of a range of PN options including APT may be central to improving the effectiveness of PN in the UK.

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Section: Discussionmentioning

confidence: 99%

“…However, the differences in professional and statutory prescribing guidance between the USA and the UK currently prevent adoption of EPT approaches in an unmodified form into routine UK practice, although some UK specialists and patients support its use. 6–8…”

Section: Introductionmentioning

confidence: 99%

Is accelerated partner therapy a feasible and acceptable strategy for rapid partner notification in the UK?: a qualitative study of genitourinary medicine clinic attenders

et al. 2009

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“…However, patient-delivered partner therapy (PDP), the intervention most likely to improve partner notification outcomes, in which antibiotics are given to the index to give to their sex partner(s) without an intervening health assessment of the partner, presents greater challenges. PDP does not comply with existing professional and legislative guidance in many countries and states, despite being popular with, and utilized by some groups of patients and clinicians 2,3 in those areas.…”

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confidence: 99%

Achieving successful partner notification: putting together the pieces of the puzzle

2009

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Partner notification as a public health measure to reduce transmission of sexually transmitted infections (STIs) is a cornerstone of STI control in most countries. The success of any partner notification strategy is conditional on its acceptability and feasibility to both patients and health-care professionals, its compliance with relevant professional and legislative guidance, and its cost-effectiveness.The diverse nature of our patient populations, the complexities of their sexual relationships, their varied emotional responses to a sexually transmitted infection (STI) diagnosis, issues of guilt and blame, and perhaps geographical separation from their partners make it unsurprising that successful partner notification is difficult to achieve. In addition, when health-care professionals lack confidence, experience or funding it is easy for partner notification to be sidelined, especially when STI care occurs outside the specialist setting.A systematic review of partner notification strategies 1 concluded that a number of relatively cheap and easy elements of care, such as provision of infection-specific information, improved partner notification outcomes, and these can, for most of us, be easily integrated into routine practice. However, patient-delivered partner therapy (PDP), the intervention most likely to improve partner notification outcomes, in which antibiotics are given to the index to give to their sex partner(s) without an intervening health assessment of the partner, presents greater challenges. PDP does not comply with existing professional and legislative guidance in many countries and states, despite being popular with, and utilized by some groups of patients and clinicians 2,3 in those areas.The very real challenge therefore remains to develop innovative, acceptable and feasible partner notification methods that satisfy current legislation and have potential to improve partner notification outcomes and that are applicable to a wide range of both specialist and non-specialist health-care settings. 4 In view of these complexities there is unlikely to be a quick fix.In this issue we report on a qualitative study of genitourinary medicine (GU) clinic attenders in outer London (Sutcliffe et al.) whose views on partner notification and individual elements of putative partner notification interventions shaped the development of two partner notification strategies which we have termed accelerated partner therapy (APT). We define APT as partner notification strategies that include assessment of the sex partner by an appropriately qualified health-care professional, but that do not require clinic attendance. These include telephone assessments by a clinic-based sexual health professional and treatment by community pharmacists and include the provision of a postal urine testing kit for Chlamydia trachomatis and Neisseria gonorrhoeae. These APT strategies satisfy current UK prescribing guidance and are undergoing evaluation in an exploratory trial, which will be reported later this year. The qualitative findi...

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“…Sir: We thank Drs Shivisankar, Challenor and Ekanayaka 1,2 for their acknowledgement of the importance of our ongoing Medical Research Council-funded study on Accelerated Partner Therapy 3 as a novel intervention for rapid partner notification in the UK setting. However, we wish to point out that it is an exploratory trial and not a randomized controlled trial (RCT) as stated in their article.…”

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confidence: 99%

Accelerated partner therapy

Estcourt¹,

Sutcliffe²

2008

Int J STD AIDS

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Sir: We thank Drs Shivisankar, Challenor and Ekanayaka 1,2 for their acknowledgement of the importance of our ongoing Medical Research Council-funded study on Accelerated Partner Therapy 3 as a novel intervention for rapid partner notification in the UK setting. However, we wish to point out that it is an exploratory trial and not a randomized controlled trial (RCT) as stated in their article. The data obtained will provide important evidence on which to base future UK recommendations for partner notification practice, as the authors suggest, and will provide robust estimates of effect for a subsequent RCT.C S Estcourt and L J Sutcliffe on behalf of the APT Study Investigators

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Patient-delivered partner therapy in the UK: what do patients think?

Cited by 12 publications

References 6 publications

Is accelerated partner therapy a feasible and acceptable strategy for rapid partner notification in the UK?: a qualitative study of genitourinary medicine clinic attenders

Is accelerated partner therapy a feasible and acceptable strategy for rapid partner notification in the UK?: a qualitative study of genitourinary medicine clinic attenders

Achieving successful partner notification: putting together the pieces of the puzzle

Accelerated partner therapy

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